慢性鼻窦炎伴鼻息肉复发患者血清MMP-2和IL-25表达与组织中肥大细胞浸润的相关性研究OA
Study on the correlation between serum MMP-2,IL-25 expression and mast cell infiltration in patients with chronic sinusitis and recurrent nasal polyps
目的 探究慢性鼻窦炎伴鼻息肉(CRSwNP)复发患者血清基质金属蛋白酶2(MMP-2)和白细胞介素25(IL-25)表达与组织中肥大细胞浸润的相关性.方法 选取2022年10月~2023年3月于都江堰市人民医院确诊为CRSwNP复发的60例患者作为CRSwNP组,另选同期于我院确诊为单纯鼻中隔偏曲(nasal septal deviation,NSD)患者60例作为NSD组.比较两组患者临床资料、肥大细胞计数及血清MMP-2和IL-25表达水平.采用局部加权回归(Lowess)分析MMP-2和IL-25水平与肥大细胞计数的相关性.应用多因素Logistic回归分析MMP-2和IL-25水平与CRSwNP复发风险的独立相关性.建立限制性立方样条(RCS)模型分析血清MMP-2和IL-25水平与CRSwNP复发风险关联强度的剂量-反应关系.通过交互作用计算表分析MMP-2和IL-25水平与肥大细胞计数对CRSwNP复发风险的交互作用及作用类型.结果 CRSwNP组Lund-Kennedy内镜评分,Lund-Mackay CT评分,总视觉模拟量表(VAS)评分,外周嗜酸性粒细胞、外周嗜碱性粒细胞、吸入过敏原、总IgE水平、吸烟、饮酒以及伴发哮喘比例、肥大细胞计数、血清MMP-2和IL-25水平明显高于NSD组,差异具有统计学意义(P<0.05).Lowess分析结果显示MMP-2和IL-25水平与肥大细胞计数之间存在一定的非线性关系.MMP-2和IL-25与CRSwNP复发存在独立相关性.RCS模型分析结果显示MMP-2和IL-25水平与CRSwNP复发风险的关联强度呈非线性剂量-反应关系(Pfor non linear=0.002,0.008).高水平组MMP-2和IL-25水平以及肥大细胞计数对应的CRSwNP复发率分别为5.26%、12.54%、19.08%,明显高于低水平组MMP-2和IL-25水平以及肥大细胞计数对应的CRSwNP复发率(55.91%、70.83%、68.05%),差异有统计学意义(P<0.05).交互作用分析结果显示,MMP-2和IL-25水平与肥大细胞计数对CRSwNP复发风险的影响在相加模型和相乘模型中存在交互作用,表现为协同作用.结论 CRSwNP复发患者血清MMP-2和IL-25水平与组织中肥大细胞浸润程度呈正相关.MMP-2和IL-25水平以及肥大细胞计数越高,CRSwNP复发率越高.MMP-2和IL-25水平与CRSwNP复发存在独立相关性,是CRSwNP复发的危险因素.
OBJECTIVE To explore the correlation between serum matrix metalloproteinase-2(MMP-2),interleukin-25(IL-25)expression and mast cell infiltration in patients with recurrent chronic sinusitis with nasal polyps(CRSwNP).METHODS Sixty patients diagnosed with recurrent CRSwNP in our hospital from October 2022 to March 2023 were selected as the CRSwNP group,and 60 patients diagnosed with simple Nasal septal deviation(NSD)in our hospital during the same period were selected as the NSD group.Compare the clinical data,mast cell count,and serum MMP-2 and IL-25 expression levels between two groups of patients.Use local weighted regression(Lowess)to analyze the correlation between MMP-2,IL-25 levels and mast cell count.Apply multiple logistic regression analysis to investigate the independent correlation between MMP-2,IL-25 levels and the risk of CRSwNP recurrence.Establish a restricted cubic spline(RCS)model to analyze the dose-response relationship between serum MMP-2,IL-25 levels and the risk of CRSwNP recurrence.Analyze the interaction and type of interaction between MMP-2,IL-25,and mast cell count on the risk of CRSwNP recurrence using an interaction calculation table.RESULTS The Lund Kennedy endoscopic score,Lund Mackay CT score,total VAS score,peripheral eosinophils,peripheral basophils,inhaled allergens,total IgE levels,smoking,alcohol consumption,and incidence of asthma,mast cell count,serum MMP-2 and IL-25 levels in the CRSwNP group were significantly higher than those in the NSD group,and the differences were statistically significant(P<0.05).Lowess analysis showed that there was a nonlinear relationship between MMP-2,IL-25 and mast cell count.MMP-2 and IL-25 were independently correlated with the recurrence of crswnp.RCS model analysis showed that MMP-2 and IL-25 levels had a nonlinear dose-response relationship with the recurrence risk of crswnp(Pfor non linear=0.002,0.008).The recurrence rates of crswnp corresponding to MMP-2,IL-25 and mast cell count in high-level group were 5.26%,12.54%and 19.08%,respectively,which were significantly higher than those corresponding to MMP-2,IL-25 and mast cell count in low-level group(55.91%,70.83%and 68.05%),and the difference was statistically significant(P<0.05).The results of interaction analysis showed that MMP-2,IL-25 and mast cell count had interaction in the additive model and the multiplicative model,showing a synergistic effect.CONCLUSION The levels of serum MMP-2 and IL-25 in CRSwNP recurrent patients are positively correlated with the degree of mast cell infiltration in the tissue.The higher the levels of MMP-2,IL-25 and Mast cell count,the higher the recurrence rate of CRSwNP.There was an independent correlation between MMP-2,IL-25 and recurrence of CRSwNP,which was a risk factor for recurrence of CRSwNP.
杨婷;罗章雨
都江堰市人民医院耳鼻咽喉科,四川 都江堰 611830都江堰市人民医院耳鼻咽喉科,四川 都江堰 611830
鼻窦炎鼻息肉基质金属蛋白酶2肥大细胞白细胞介素25
SinusitisNasal PolypsMatrix Metalloproteinase 2Mast Cellsinterleukin-25
《中国耳鼻咽喉头颈外科》 2025 (3)
169-174,6
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